Anti-choice Republicans militating against federal funding of family planning threaten to wreck vital work against HIV infection

Around the world, people are fascinated by the political tussle between Democrats and Republicans over attempts to repeal the landmark US healthcare bill passed last year. Few people realise, however, that if the new Republican-dominated House of Representatives gets its way, it won’t just be Americans who are affected. As part of his repeal effort, House speaker John Boehner is intent on reintroducing the “global gag” rule, a policy that would endanger the lives of millions of women worldwide. America’s culture wars may be coming to a country near you.

The global gag rule, officially known as the Mexico City policy, was introduced by the Reagan administration in 1984, during the United Nation’s International Conference on Population in Mexico City. The policy prevents US overseas assistance from going to organisations that provide information on abortion, perform abortions or direct women to abortion providers.

Because the rule denies funding to organisations that simply counsel women on abortion issues, not just those that perform abortion, family planning Women from developing countries have been let down by the UN, say charitiesfacilities around the world cut back services, close facilities and raise their fees to cover lost income thereby reducing access to their services. These services include contraceptive distribution vital to the prevention of HIV/Aids. When George W Bush restarted the ideological war against family planning by reintroducing the gag rule in 2001, shipments of condoms and contraceptives from USAID was immediately halted to 16 countries. The impact was devastating.

Population Action International, an independent research organisation on family planning, reported that in Kenya five of the most established family planning clinics closed – many of which were the only affordable options in their areas. In Lesotho, where one quarter of women suffer from HIV/Aids, all condom donations from USAID were cut off. With fewer organisations to counsel on safe sex, and with fewer or no contraceptives to distribute, the gag rule actually increases the spread of HIV/Aids in some of the worse affected countries. This, of course, runs directly against official American policy aimed at reducing the number of global HIV infections.

Even more perversely, the policy is self-defeating. Research illustrates that instead of curbing abortions, the number of abortions increased. Countries with family planning services have lower rates of abortion than those without. Because women cannot get access to contraceptives and advice, they end up reliant on the last ditch option when pregnant: abortion. Often, desperate women resort to dangerous non-clinical practices in the absence of professional medical care. The results are horrific and inhumane.

Republicans are quick to accuse those who advocate for a woman’s right to chose of being pro-abortion. The reality is that we are pro-health. Being pro-choice is not equivalent to being pro-abortion. Rather, we understand that this is an issue best left to a woman and her doctor. Abortion is a fact of life, like it or not, and studies have shown that one of the best ways to reduce abortions is to offer preventive family planning, as well as immediate post-abortion family planning and counselling. The figures from one study on immediate post-abortion counselling in Turkey are revealing: the number of clients using contraception after an abortion and subsequent counselling rose from 67% to 91% in one year; and the number of abortions dropped over the decade from 4,100 in 1992 to 1,709 in 1998.

The global gag rule undermines America’s HIV/Aids policy, it risks the lives of countless women and it undermines a core American value – the freedom of speech. Women should have access to a wide variety of family planning and health counselling that should include everything from abstinence to abortion. To argue otherwise, given the evidence at hand, is not just reprehensible; it is immoral.